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Day G, Collins J, Twohig C, De Silva K, Brimblecombe J. Towards healthy food retail: An assessment of public health nutrition workforce capacity to work with stores. Aust N Z J Public Health 2023; 47:100056. [PMID: 37182502 DOI: 10.1016/j.anzjph.2023.100056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 03/27/2023] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVE This article aims to investigate the capacity of nutrition professionals to engage in food retail practice change to improve population diet. METHODS Convergent mixed method design was used that includes pre-interview surveys, in-depth interviews, and retrospective mapping of service provision. The study was conducted in organisations that provide a nutrition professional service to food retail stores in remote Australia. The study participants include 11 nutrition professionals and eight organisation representatives, including managers, organisation directors and policy officers. Systems-mapping and thematic analysis of the in-depth interviews were conducted using a capacity development framework. Descriptive analysis was applied to pre-interview survey and mapping data. RESULTS A gap between the aspirational work and current capacity of nutrition professionals to engage effectively with stores was identified. Engagement with stores to improve population health was valued by organisations. Dominance of the medical health model limited organisation strategic support for store work and created barriers. Key barriers included the limited access to training, decision-support tools, information, financial resources and organisational structures that directed store work. CONCLUSIONS Provision of adequate store-specific training, resources and organisational support may empower the nutrition professional workforce to be powerful leaders in co-design for healthy food retail. IMPLICATIONS FOR PUBLIC HEALTH Building capacity for this critical workforce to engage in food retail practice change must consider the influence of the broader health system and employer organisations and need for access to evidence-based decision-support tools.
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Affiliation(s)
- Georgia Day
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia
| | - Jorja Collins
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia
| | - Cliona Twohig
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia
| | - Khia De Silva
- Arnhem Land Progress Aboriginal Corporation (ALPA), 70 O'Sullivan Circuit, East Arm, Northern Territory, 0822, Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria, 3168, Australia; Menzies School of Health Research, John Mathews Building (58), Royal Darwin Hospital Campus, 58 Rocklands Dr, Tiwi, NT, 0810, Australia.
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Wilson A, Cornett M, Delbridge R, Mackean T, Palermo C. A realist evaluation of a community of practice for dietitians and nutritionists working in Aboriginal and Torres Strait Islander health. J Hum Nutr Diet 2023; 36:277-287. [PMID: 35614859 PMCID: PMC10084382 DOI: 10.1111/jhn.13043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/19/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Communities of practice have been proposed as a workforce development strategy for developing dietitians, yet little is known about how they work and for whom, as well as under what circumstances. We aimed to understand the mechanisms by which dietitians working in Aboriginal and Torres Strait Islander health benefit from communities of practice. METHODS A realist evaluation of 29 interviews with non-Indigenous dietitians and nutritionists was employed, which was conducted over the course of two communities of practice (2013 and 2014) and follow-up interviews in 2019. Programme theory was developed from analysis of initial interviews and used to recode all interviews and test theory. The identification of patterns refined the programme theory. RESULTS Six refined theories were identified: (1) a community of practice fosters the relationships that support navigation of the many tasks required to become more responsive health professionals; (2) committed and open participants feel supported and guided to be reflexive; (3) sharing, reflexivity, feedback and support shift awareness to one's own practice to be able to manoeuvre in intercultural spaces; (4) through sharing, feedback, support and collaboration, participants feel assured and affirmed; (5) connection through feelings of understanding and being understood contributes to commitment to remain working in the area; and (6) through sharing, feedback, support and collaboration, participants with varied experience and roles see the value of and gain confidence in new perspectives, skills and practices. CONCLUSIONS Further research is required to test this model on a much larger scale, with communities of practice inclusive of Aboriginal and non-Aboriginal health professionals together, and across a diverse group of dietitians.
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Affiliation(s)
- Annabelle Wilson
- School of Health Sciences, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Marian Cornett
- Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Robyn Delbridge
- Swinburne University of Technology, Melbourne, VIC, Australia.,School of Allied Health, Human Services & Sport, La Trobe University Melbourne, Melbourne, VIC, Australia
| | - Tamara Mackean
- School of Health Sciences, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Claire Palermo
- Monash Centre for Scholarship in Health Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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Wynn E, Palermo C, Delbridge R, Wilson A. Long-Term Outcomes of a Community of Practice for Dietitians Working in Aboriginal and Torres Strait Islander Health: A Multimethod, Follow-up Study. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2022; 42:e60-e68. [PMID: 34108390 DOI: 10.1097/ceh.0000000000000370] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Dietitians are in an important position to work alongside Aboriginal and Torres Strait Islander peoples to improve their health and may play a role in reducing the burden of disease experienced by Aboriginal and Torres Strait Islander peoples. Many dietitians do not feel confident to practice effectively in these settings and require improved workforce development opportunities. Communities of Practice can improve dietitians' confidence and practice in Aboriginal and Torres Strait Islander health; however, evidence for long-term impacts is limited. This study aims to determine if a Community of Practice can have long-term impacts on dietitians working in Aboriginal and Torres Strait Islander health. METHODS Data were collected through semistructured interviews and a cultural awareness self-assessment tool. Analysis was through a multimethod approach and combined qualitative inductive thematic analysis, social network analysis, and descriptive statistics. RESULTS Three main areas of long-term impact were identified including development of a social and professional network, career progression and retention, and a fundamental change in thinking and practice. All participants experienced feelings of support and increased confidence. DISCUSSION Communities of practice may be a feasible, low-cost workforce development strategy that can reduce dietitians' feelings of professional isolation when working in Aboriginal and Torres Strait Islander health. Further research is required to identify the mechanisms underlying sustained impacts. Social network analysis, combined with realist evaluation may be an appropriate research design, to answer future and more in-depth questions about the effectiveness of communities of practice.
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Affiliation(s)
- Ellen Wynn
- Ms. Wynn: Accredited Practicing Dietitian (APD). Ms. Palermo: Fellow of the Dietetics Association of Australia (FDAA), Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia. Ms. Delbridge: Advanced Accredited Practicing Dietitian (AdvAPD), Department of Nursing and Allied Health, Swinburne University of Technology, Melbourne, Australia. Ms. Wilson: Advanced Accredited Practicing Dietitian (AdvAPD), College of Medicine and Public Health, Flinders University, South Australia
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Blair M, Mitchell L, Palermo C, Gibson S. Trends, challenges, opportunities, and future needs of the dietetic workforce: a systematic scoping review. Nutr Rev 2021; 80:1027-1040. [PMID: 34532738 DOI: 10.1093/nutrit/nuab071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
CONTEXT Issues related to nutrition and health are prominent, yet it is unclear if the dietetics workforce is being used optimally. OBJECTIVE Trends, challenges, opportunities, and future needs of the international dietetic workforce are investigated in this review, which was registered with Open Science Framework (10.17605/OSF.IO/DXNWE). DATA SOURCES Eight academic and 5 grey-literature databases and the Google search engine were searched from 2010 onward according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Of 2050 articles screened, 184 were eligible for inclusion. DATA EXTRACTION To chart data, a directed content analysis and a constant comparison technique were used. DATA ANALYSIS The following 13 themes were identified: 1) emerging or expanding areas of practice; 2) skill development; 3) economic considerations; 4) nutrition informatics; 5) diversity within the workforce; 6) specific areas of practice; 7) further education; 8) intrapersonal factors; 9) perceptions of the profession; 10) protecting the scope of practice; 11) support systems; 12) employment outcomes; and 13) registration or credentialing. CONCLUSIONS The dietetics profession is aware of the need to expand into diverse areas of employment. Comprehensive workforce data are necessary to facilitate workforce planning.
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Affiliation(s)
- Merran Blair
- M. Blair and C. Palermo are with the Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Lana Mitchell
- L. Mitchell is with the School of Allied Health Sciences, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Claire Palermo
- M. Blair and C. Palermo are with the Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia
| | - Simone Gibson
- S. Gibson is with the School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
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El-Kour TY, Kelley K, Bruening M, Robson S, Vogelzang J, Yang J, Jimenez EY. Dietetic Workforce Capacity Assessment for Public Health Nutrition and Community Nutrition. J Acad Nutr Diet 2021; 121:1379-1391.e21. [PMID: 34344516 PMCID: PMC7577731 DOI: 10.1016/j.jand.2020.08.078] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/29/2020] [Accepted: 08/17/2020] [Indexed: 11/26/2022]
Abstract
Worldwide, there is a continued rise in malnutrition and noncommunicable disease, along with rapidly changing dietary patterns, demographics, and climate and persistent economic inequality and instability. These trends have led to a national and global focus on nutrition-specific and nutrition-sensitive interventions to improve population health. A well-trained public health and community nutrition workforce is critical to manage and contribute to these efforts. The study describes the current public health and community nutrition workforce and factors influencing registered dietitian nutritionists (RDNs) to work in these settings and characterizes RDN preparedness, training, and competency in public health and community nutrition. The study was comprised of a cross-sectional, online survey of mostly US RDNs working in public health/community nutrition and semistructured telephone interviews with US-based and global public health and community nutrition experts. RStudio version 1.1.442 was used to manage and descriptively analyze survey data. Thematic analysis was conducted to evaluate expert interviews. Survey participants (n = 316) were primarily women (98%) and White (84%) with the RDN credential (91%) and advanced degrees (65%). Most reported that non-RDNs are performing nutrition-related duties at their organizations. Respondents generally rated themselves as better prepared to perform community nutrition vs public health functions. Interviews were conducted with 7 US-based experts and 5 international experts. Experts reported that non-RDNs often fill nutrition-related positions in public health, and RDNs should more actively pursue emerging public health opportunities. Experts suggested that RDNs are more desirable job candidates if they have advanced public health degrees or prior experience in public health or community nutrition and that dietetic training programs need to more rigorously incorporate public health training and experience. Significant opportunity exists to improve the preparedness and training of the current dietetic workforce to increase capacity and meet emerging needs in public health and community nutrition.
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Affiliation(s)
- Tatyana Y El-Kour
- Global Health and Nutrition Consultant and Independent Researcher, Anman, Jordan.
| | - Kathryn Kelley
- Nutrition Research Network, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, IL
| | - Meg Bruening
- College of Health Solutions, Arizona State University, Phoenix, AZ
| | - Shannon Robson
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE
| | | | - Jimin Yang
- Health Informatics Institute, University of South Florida, Tampa, FL
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Landry MJ, Bailey DA, Ervin A. You Are Not an Impostor: The Registered Dietitian Nutritionist and Impostor Phenomenon. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:625-630. [PMID: 33775568 DOI: 10.1016/j.jneb.2021.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/16/2021] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
Impostor phenomenon (IP) interferes with the desire for taking advantage of career opportunities and pursuing career advancement. There is robust literature describing the effects of IP in other health care professions, yet an absence of research exists on IP within the nutrition and dietetics profession. This perspective will explore why nutrition and dietetics professionals may experience IP, specify what might be done to mitigate the negative effects of IP, and describe future research directions. Impostorism is an understudied phenomenon that could have significant implications for the profession of nutrition and dietetics on an individual and systemic level.
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Affiliation(s)
- Matthew J Landry
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA.
| | | | - Audrey Ervin
- Department of Counseling Psychology, Delaware Valley University, Doylestown, PA
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Kikomeko PK, Ochola S, Kaaya AN, Ogada I, Birungi TL, Nakitto P. Stakeholders' perceptions of the nutrition and dietetics needs and the requisite professional competencies in Uganda: a cross-sectional mixed methods study. BMC Health Serv Res 2021; 21:92. [PMID: 33504348 PMCID: PMC7839220 DOI: 10.1186/s12913-021-06090-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 01/14/2021] [Indexed: 11/30/2022] Open
Abstract
Background Effective implementation of nutrition and dietetics interventions necessitates professionals in these fields to possess the requisite competencies for health systems performance. This study explored the stakeholders’ perceptions of the community nutrition and dietetics needs, the nature of work done by graduates of the Bachelor’s degree in Human Nutrition/Human Nutrition and Dietetics (HN/HND), and the competencies required of Nutrition and Dietetics professionals in Uganda. Methods A cross-sectional mixed methods design was used. Respondents included 132 graduates of the Bachelor’s degrees in HN/HND obtained from the Makerere and Kyambogo Universities in 2005–2016; 14 academic staff that train HN/HND in the two universities; and 11 HN/HND work/internship supervisors. Data from the graduates was collected through an email-based survey; data from other participants was through face to face interviews using researcher administered questionnaires. Results Most HN/HND respondents (84.8%) obtained their Bachelor’s degrees from Kyambogo University; 61.4% graduated in 2013–2016. Most (64.3%) academic staff respondents were females and the majority (57.1%) had doctorate training. All stakeholders viewed communities as facing a variety of nutrition and dietetics challenges cutting across different Sustainable Development Goals. The nutrition and dietetics interventions requested for, provided, and considered a priority for communities were both nutrition-specific and nutrition-sensitive. Work done by HN/HND graduates encompassed seven main competency domains; the dominant being organizational leadership and management; management of nutrition-related disease conditions; nutrition and health promotion; research; and advocacy, communication, and awareness creation. Conclusions This study shows that nutrition and dietetics challenges in Uganda are multiple and multifaceted; HN/HND graduates are employed in different sectors, provide nutrition-specific and sensitive services in a multisectoral environment, and are expected to possess a variety of knowledge and skills. However, graduates have knowledge and skills gaps in some of the areas they are expected to exhibit competency. We recommend using these findings as a basis for obtaining stakeholder consensus on the key competencies that should be exhibited by all HN/HND graduates in Uganda; developing a HN/HND competency-based education model and a national HN/HND training and practice standard; and undertaking further research to understand the quality and relevancy of HN/HND curricula to Uganda’s job market requirements. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06090-3.
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Affiliation(s)
- Peterson Kato Kikomeko
- Department of Food, Nutrition, and Dietetics, Kenyatta University, P.O Box 43844, Nairobi, Kenya. .,Department of Human Nutrition and Home Economics, Kyambogo University, P.O Box, 1 Kyambogo, Kampala, Uganda.
| | - Sophie Ochola
- Department of Food, Nutrition, and Dietetics, Kenyatta University, P.O Box 43844, Nairobi, Kenya
| | - Archileo N Kaaya
- School of Food Technology, Nutrition and Bioengineering, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Irene Ogada
- Department of Food, Nutrition, and Dietetics, Kenyatta University, P.O Box 43844, Nairobi, Kenya.,Department of Human Nutrition, St. Francis Xavier University, Antigonish, Canada
| | | | - Peace Nakitto
- Elizabeth Glaser Pediatric AIDS Foundation, Mbarara, Uganda.,Self Help Africa, Kampala, Uganda
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Mentorship Experiences and Perceptions of Didactic Program in Dietetics Students. TOP CLIN NUTR 2021. [DOI: 10.1097/tin.0000000000000229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Burt KG, Delgado K, Chen M, Paul R. Strategies and Recommendations to Increase Diversity in Dietetics. J Acad Nutr Diet 2019; 119:733-738. [DOI: 10.1016/j.jand.2018.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Indexed: 10/14/2022]
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Morgan K, Kelly JT, Campbell KL, Hughes R, Reidlinger DP. Dietetics workforce preparation and preparedness in Australia: A systematic mapping review to inform future dietetics education research. Nutr Diet 2018; 76:47-56. [DOI: 10.1111/1747-0080.12450] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/24/2018] [Accepted: 06/02/2018] [Indexed: 01/10/2023]
Affiliation(s)
- Kate Morgan
- Faculty of Health Sciences and Medicine; Bond University; Gold Coast Queensland Australia
| | - Jaimon T. Kelly
- Faculty of Health Sciences and Medicine; Bond University; Gold Coast Queensland Australia
| | - Katrina L. Campbell
- Faculty of Health Sciences and Medicine; Bond University; Gold Coast Queensland Australia
| | - Roger Hughes
- School of Medicine; University of Tasmania; Hobart Tasmania Australia
| | - Dianne P. Reidlinger
- Faculty of Health Sciences and Medicine; Bond University; Gold Coast Queensland Australia
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Barbour L, Armstrong R, Condron P, Palermo C. Communities of practice to improve public health outcomes: a systematic review. JOURNAL OF KNOWLEDGE MANAGEMENT 2018. [DOI: 10.1108/jkm-03-2017-0111] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Communities of practice (CoPs) exist to enable people to share knowledge, innovate and progress a common field of practice. This paper aims to identify whether CoPs have a measured impact on public health practice and the tools used to measure the impact and potential barriers and facilitators that may have been identified during the implementation of these CoPs.
Design/methodology/approach
A systematic review of the literature was conducted using PRISMA guidelines. Searches of six databases, Google Scholar and a citation search were completed. Included studies were from 1986 to 2016, involved the public health workforce and an evaluation of a CoP -like intervention. A narrative synthesis of the findings was conducted.
Findings
From 3,021 publications, 12 studies met inclusion criteria and described the impact of ten CoPs amongst public health practitioners from America, Canada, Australasia and the United Kingdom. CoPs support the prevention workforce to change their practice when they provide structured problem-solving, reflective practice and networking opportunities. None of the studies described the impact of CoPs on public health outcomes.
Practical implications
CoPs that provide structured problem-solving, reflective practice and diverse networking may effectively support the public health workforce. Existing methods used to evaluate CoPs lack rigour; thus, the true impact of CoPs on population health remains unknown.
Originality/value
This is the first known systematic review that has measured the impact of CoPs on the preventative health workforce and the conditions in which they have an impact.
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Svarc R, Davis C, McDonald H, Perruzza J, Browne J, Delbridge R, Morgan K, O'Reilly S, Margerison C, Palermo C. Exploring the impact of Aboriginal health placement experiences on the preparation of dietetic graduates for practice with Aboriginal communities. Nutr Diet 2018; 75:448-456. [PMID: 29436176 DOI: 10.1111/1747-0080.12407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 12/19/2017] [Accepted: 01/01/2018] [Indexed: 11/30/2022]
Abstract
AIM A health workforce with the ability to practice with Aboriginal communities is crucial to bridge the health gap between Aboriginal and non-Aboriginal Australians. This study aimed to explore the impact of university Aboriginal health placements on preparing dietetic graduates for practice with Aboriginal communities. METHODS A mixed methods sequential explanatory design was used. A sample of 594 dietetic graduates was invited to complete a survey that identified Aboriginal health experiences and measured attitudes and self-confidence towards working in Aboriginal health using a five-point Likert scale. Participants were divided into placement versus no-placement groups and compared using chi-squared tests. Sixteen of 33 participants who had completed an Aboriginal health placement were invited to participate in a semi-structured interview to explore how placement influenced practice with Aboriginal communities. Interviews were analysed using content analysis. RESULTS A final sample of 120 participants showed that placement participants reported significantly higher self-confidence towards working in Aboriginal health compared with no-placement participants (No-placement = 35% agree, 36% neutral, 29% disagree; Placement = 74% agree, 11% neutral, 16% disagree; χ2 (2, 88) = 9.4; P = 0.01). Fifteen participants were interviewed. Interview data indicated that situated learning experiences, breaking down stereotypes, empathy through learning from Aboriginal people, and Aboriginal health role-models were key components of Aboriginal health placements in preparing dietetic graduates for practice with Aboriginal communities. CONCLUSIONS The results suggest that Aboriginal health placements may be an effective strategy for preparing dietetic graduates for practice with Aboriginal communities. The feasibility of placement or alternative curriculum content needs to be explored.
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Affiliation(s)
- Ruby Svarc
- Department of Nutrition and Dietetics, Monash University, Melbourne, Victoria, Australia
| | - Corinne Davis
- Department of Nutrition and Dietetics, Monash University, Melbourne, Victoria, Australia
| | - Helena McDonald
- Department of Nutrition and Dietetics, Monash University, Melbourne, Victoria, Australia
| | - Julia Perruzza
- Department of Nutrition and Dietetics, Monash University, Melbourne, Victoria, Australia
| | - Jennifer Browne
- Public Health and Research Unit, The Victorian Aboriginal Community Controlled Health Organisation, Melbourne, Victoria, Australia
| | - Robyn Delbridge
- Public Health and Research Unit, The Victorian Aboriginal Community Controlled Health Organisation, Melbourne, Victoria, Australia
| | - Keith Morgan
- Public Health and Research Unit, The Victorian Aboriginal Community Controlled Health Organisation, Melbourne, Victoria, Australia
| | - Sharleen O'Reilly
- UCD Agriculture and Food Science Centre, University College Dublin, Dublin, Ireland
| | - Claire Margerison
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia
| | - Claire Palermo
- Department of Nutrition and Dietetics, Monash University, Melbourne, Victoria, Australia
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ALMEIDA GMD, OLIVEIRA KHDD, MONTEIRO JS, MEDEIROS MATD, RECINE EGIG. Educational training of nutritionists in Public Health Nutrition: A systematic review. REV NUTR 2018. [DOI: 10.1590/1678-98652018000100009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT The present systematic review aimed to synthesize the findings of studies in the literature on the educational training of nutritionists in Public Health. The study was conducted by searching international databases (PubMed, Science Direct, Lilacs, PsycINFO, Scopus, and Web of Science), as well as in the gray literature. The steps of systematic search followed the recommendations of the Preferred Reporing Itens for Systematic Reviews and Meta-Analysis. Eligibility criteria included studies on the Public Health training in Nutrition Undergraduate courses, whose subjects were students, educators, and professionals who practice in the field of Nutrition. A total of 633 articles were identified, of which, 66 were eligible for reading and analysis of the full text and 12 were included in the systematic review. Of these, five of these 12 articles used quantitative methods, 3 used mixed methods, and 4 used exclusively qualitative methods. There was high heterogeneity among the studies, such as different samples, subjects, and evaluation methods. The studies included were carried out from 2008 to 2017 in 28 different countries, including Brazil, Canada, Vietnam, and some European countries. In most of these articles, Public Health was one of the main areas in the formal education of nutritionists, with predominant traditional teaching approach, with a biological focus and a fragmented curricular structure. The included studies were evaluated with low risk of bias. In spite of the limitations identified in the professional training of nutritionists, there was a clear emphasis on the importance of the relationship between theory and practice, teaching-research-extension approaches, and practical activities or internships in Public Health, which can promote the development of skills and competencies that can exert an impact on their professional performance.
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Harper C, Maher J. Investigating Philosophies Underpinning Dietetic Private Practice. Behav Sci (Basel) 2017; 7:E11. [PMID: 28257036 PMCID: PMC5371755 DOI: 10.3390/bs7010011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/06/2017] [Accepted: 02/21/2017] [Indexed: 11/25/2022] Open
Abstract
There is limited theory or knowledge regarding dietitians' practice philosophies and how these philosophies are generated and incorporated into their professional practices. For the purposes of this study, a conceptual framework will explain and define the 'philosophies' as three different types of knowledge; episteme, techne, and phronesis. This study aimed to develop an explanatory theory of how dietitians in private practice source, utilise, and integrate practice philosophies. A grounded theory qualitative methodology was used to inform the sampling strategy, data collection, and analytical processes. Semi-structured interviews with dietitians in private practice were undertaken and data were collected and analysed concurrently. The results show that dietitians form collaborative relationships with their clients, in order to nurture change over time. They use intrinsic and intertwined forms of episteme, techne, and phronesis, which allow them to respond both practically and sensitively to their clients' needs. The learning and integration of these forms of knowledge are situated in their own practice experience. Dietitians adapt through experience, feedback, and reflection. This study highlights that private practice offers a unique context in which dietitians deal with complex issues, by utilising and adapting their philosophies.
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Affiliation(s)
- Claudia Harper
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, The University of Sydney, Level 2, Charles Perkins Centre, John Hopkins Drive, Camperdown, NSW 2006, Australia.
| | - Judith Maher
- Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, 90 Sippy Downs Dr, Sippy Downs, QLD 4556, Australia.
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Shrimpton R, du Plessis LM, Delisle H, Blaney S, Atwood SJ, Sanders D, Margetts B, Hughes R. Public health nutrition capacity: assuring the quality of workforce preparation for scaling up nutrition programmes. Public Health Nutr 2016; 19:2090-100. [PMID: 26857753 PMCID: PMC10271189 DOI: 10.1017/s136898001500378x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 12/13/2015] [Accepted: 12/16/2015] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To describe why and how capacity-building systems for scaling up nutrition programmes should be constructed in low- and middle-income countries (LMIC). DESIGN Position paper with task force recommendations based on literature review and joint experience of global nutrition programmes, public health nutrition (PHN) workforce size, organization, and pre-service and in-service training. SETTING The review is global but the recommendations are made for LMIC scaling up multisectoral nutrition programmes. SUBJECTS The multitude of PHN workers, be they in the health, agriculture, education, social welfare, or water and sanitation sector, as well as the community workers who ensure outreach and coverage of nutrition-specific and -sensitive interventions. RESULTS Overnutrition and undernutrition problems affect at least half of the global population, especially those in LMIC. Programme guidance exists for undernutrition and overnutrition, and priority for scaling up multisectoral programmes for tackling undernutrition in LMIC is growing. Guidance on how to organize and scale up such programmes is scarce however, and estimates of existing PHN workforce numbers - although poor - suggest they are also inadequate. Pre-service nutrition training for a PHN workforce is mostly clinical and/or food science oriented and in-service nutrition training is largely restricted to infant and young child nutrition. CONCLUSIONS Unless increased priority and funding is given to building capacity for scaling up nutrition programmes in LMIC, maternal and child undernutrition rates are likely to remain high and nutrition-related non-communicable diseases to escalate. A hybrid distance learning model for PHN workforce managers' in-service training is urgently needed in LMIC.
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Affiliation(s)
- Roger Shrimpton
- Department of Global Community Health and Behavioural Sciences, Tulane School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA
| | - Lisanne M du Plessis
- Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Hélène Delisle
- Département de nutrition, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Sonia Blaney
- École des sciences des aliments, de nutrition et d'études familiales, Faculté des sciences de la santé et des services communautaires, Université de Moncton, Moncton, NB, Canada
| | - Stephen J Atwood
- School of Global Studies, Thammasat University, Rangsit, Pathum Thani, Thailand
| | - David Sanders
- School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Barrie Margetts
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Roger Hughes
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
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Buttenshaw K, Ash S, Shakespeare-Finch J. Development and validation of the Dietetic Confidence Scale for working with clients experiencing psychological issues. Nutr Diet 2016; 74:36-45. [DOI: 10.1111/1747-0080.12294] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 03/22/2016] [Accepted: 05/06/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Kerryn Buttenshaw
- School of Psychology and Counselling; Queensland University of Technology (QUT)/Institute of Health and Biomedical Innovation; Brisbane Queensland Australia
| | - Susan Ash
- School of Exercise and Nutrition Sciences, Faculty of Health; Queensland University of Technology (QUT)/Institute of Health and Biomedical Innovation; Brisbane Queensland Australia
| | - Jane Shakespeare-Finch
- School of Psychology and Counselling; Queensland University of Technology (QUT)/Institute of Health and Biomedical Innovation; Brisbane Queensland Australia
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Promoting Diversity within the Dietetics Profession through a Peer Mentorship Program. J Acad Nutr Diet 2016; 116:198-202. [DOI: 10.1016/j.jand.2015.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Indexed: 11/23/2022]
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Gifford J, Snell R. Barriers and enablers to applying for the Dietitians Association of Australia Advanced Accredited Practising Dietitian credential: A qualitative analysis. Nutr Diet 2014. [DOI: 10.1111/1747-0080.12151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Janelle Gifford
- Consultancy; Core Nutrition; Engadine New South Wales Australia
- University of Sydney; Sydney New South Wales Australia
| | - Robynne Snell
- Nutrition, Dietetics and Food Technology; Curtin University; Perth Western Australia Australia
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Black C, Lawrence W, Cradock S, Ntani G, Tinati T, Jarman M, Begum R, Inskip H, Cooper C, Barker M, Baird J. Healthy conversation skills: increasing competence and confidence in front-line staff. Public Health Nutr 2014; 17:700-7. [PMID: 22989477 PMCID: PMC3776723 DOI: 10.1017/s1368980012004089] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 06/11/2012] [Accepted: 08/01/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE (i) To assess change in confidence in having conversations that support parents with healthy eating and physical activity post-training. (ii) To assess change in staff competence in using 'open discovery' questions (those generally beginning with 'how' and 'what' that help individuals reflect and identify barriers and solutions) post-training. (iii) To examine the relationship between confidence and competence post-training. DESIGN A pre-post evaluation of 'Healthy Conversation Skills', a staff training intervention. SETTING Sure Start Children's Centres in Southampton, England. SUBJECTS A total of 145 staff working in Sure Start Children's Centres completed the training, including play workers (43%) and community development or family support workers (35%). RESULTS We observed an increase in median confidence rating for having conversations about healthy eating and physical activity (both P < 0·001), and in using 'open discovery' questions (P < 0·001), after staff attended the 'Healthy Conversation Skills' training. We also found a positive relationship between the use of 'open discovery' questions and confidence in having conversations about healthy eating post-training (r = 0·21, P = 0·01), but a non-significant trend was observed for having conversations about physical activity (r = 0·15, P = 0·06). CONCLUSIONS The 'Healthy Conversation Skills' training proved effective at increasing the confidence of staff working at Sure Start Children's Centres to have more productive conversations with parents about healthy eating. Wider implementation of these skills may be a useful public health nutrition capacity building strategy to help community workers support families with young children to eat more healthy foods.
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Affiliation(s)
- Christina Black
- Medical Research Council Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
- NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, Southampton University NHS Hospitals Trust, Southampton, UK
| | - Wendy Lawrence
- Medical Research Council Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - Sue Cradock
- NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, Southampton University NHS Hospitals Trust, Southampton, UK
| | - Georgia Ntani
- Medical Research Council Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - Tannaze Tinati
- Medical Research Council Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - Megan Jarman
- Medical Research Council Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
- NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, Southampton University NHS Hospitals Trust, Southampton, UK
| | - Rufia Begum
- Medical Research Council Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
- NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, Southampton University NHS Hospitals Trust, Southampton, UK
| | - Hazel Inskip
- Medical Research Council Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - Mary Barker
- Medical Research Council Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
| | - Janis Baird
- Medical Research Council Lifecourse Epidemiology Unit (University of Southampton), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
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Browne J, Thorpe S, Tunny N, Adams K, Palermo C. A qualitative evaluation of a mentoring program for Aboriginal health workers and allied health professionals. Aust N Z J Public Health 2013; 37:457-62. [DOI: 10.1111/1753-6405.12118] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Sunguya BF, Poudel KC, Mlunde LB, Urassa DP, Yasuoka J, Jimba M. Nutrition training improves health workers' nutrition knowledge and competence to manage child undernutrition: a systematic review. Front Public Health 2013; 1:37. [PMID: 24350206 PMCID: PMC3859930 DOI: 10.3389/fpubh.2013.00037] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 09/09/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Medical and nursing education lack adequate practical nutrition training to fit the clinical reality that health workers face in their practices. Such a deficit creates health workers with poor nutrition knowledge and child undernutrition management practices. In-service nutrition training can help to fill this gap. However, no systematic review has examined its collective effectiveness. We thus conducted this study to examine the effectiveness of in-service nutrition training on health workers' nutrition knowledge, counseling skills, and child undernutrition management practices. METHODS We conducted a literature search on nutrition interventions from PubMed/MEDLINE, CINAHL, EMBASE, ISI Web of Knowledge, and World Health Organization regional databases. The outcome variables were nutrition knowledge, nutrition-counseling skills, and undernutrition management practices of health workers. Due to heterogeneity, we conducted only descriptive analyses. RESULTS Out of 3910 retrieved articles, 25 were selected as eligible for the final analysis. A total of 18 studies evaluated health workers' nutrition knowledge and showed improvement after training. A total of 12 studies with nutrition counseling as the outcome variable also showed improvement among the trained health workers. Sixteen studies evaluated health workers' child undernutrition management practices. In all such studies, child undernutrition management practices and competence of health workers improved after the nutrition training intervention. CONCLUSION In-service nutrition training improves quality of health workers by rendering them more knowledge and competence to manage nutrition-related conditions, especially child undernutrition. In-service nutrition training interventions can help to fill the gap created by the lack of adequate nutrition training in the existing medical and nursing education system. In this way, steps can be taken toward improving the overall nutritional status of the child population.
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Affiliation(s)
- Bruno F Sunguya
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
| | - Krishna C Poudel
- Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts Amherst , Amherst, MA , USA
| | - Linda B Mlunde
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
| | - David P Urassa
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences , Dar es Salaam , Tanzania
| | - Junko Yasuoka
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo , Tokyo , Japan
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Hughes R, Margetts B. The public health nutrition intervention management bi-cycle: a model for training and practice improvement. Public Health Nutr 2012; 15:1981-8. [PMID: 21859511 PMCID: PMC10271403 DOI: 10.1017/s1368980011002011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 06/25/2011] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The present paper describes a model for public health nutrition practice designed to facilitate practice improvement and provide a step-wise approach to assist with workforce development. DESIGN The bi-cycle model for public health nutrition practice has been developed based on existing cyclical models for intervention management but modified to integrate discrete capacity-building practices. SETTING Education and practice settings. SUBJECTS This model will have applications for educators and practitioners. RESULTS Modifications to existing models have been informed by the authors' observations and experiences as practitioners and educators, and reflect a conceptual framework with applications in workforce development and practice improvement. From a workforce development and educational perspective, the model is designed to reflect adult learning principles, exposing students to experiential, problem-solving and practical learning experiences that reflect the realities of work as a public health nutritionist. In doing so, it assists the development of competency beyond knowing to knowing how, showing how and doing. This progression of learning from knowledge to performance is critical to effective competency development for effective practice. CONCLUSIONS Public health nutrition practice is dynamic and varied, and models need to be adaptable and applicable to practice context to have utility. The paper serves to stimulate debate in the public health nutrition community, to encourage critical feedback about the validity, applicability and utility of this model in different practice contexts.
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Affiliation(s)
- Roger Hughes
- School of Public Health, Griffith University, Gold Coast, Queensland, Australia.
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Kugelberg S, Jonsdottir S, Faxelid E, Jönsson K, Fox A, Thorsdottir I, Yngve A. Public health nutrition workforce development in seven European countries: constraining and enabling factors. Public Health Nutr 2012; 15:1989-98. [PMID: 22894796 PMCID: PMC10271757 DOI: 10.1017/s1368980012003874] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 07/05/2012] [Accepted: 07/05/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Little is known about current public health nutrition workforce development in Europe. The present study aimed to understand constraining and enabling factors to workforce development in seven European countries. DESIGN A qualitative study comprised of semi-structured face-to-face interviews was conducted and content analysis was used to analyse the transcribed interview data. SETTING The study was carried out in Finland, Iceland, Ireland, Slovenia, Spain, Sweden and the UK. SUBJECTS Sixty key informants participated in the study. RESULTS There are constraining and enabling factors for public health nutrition workforce development. The main constraining factors relate to the lack of a supportive policy environment, fragmented organizational structures and a workforce that is not cohesive enough to implement public health nutrition strategic initiatives. Enabling factors were identified as the presence of skilled and dedicated individuals who assume roles as leaders and change agents. CONCLUSIONS There is a need to strengthen coordination between policy and implementation of programmes which may operate across the national to local spectrum. Public health organizations are advised to further define aims and objectives relevant to public health nutrition. Leaders and agents of change will play important roles in fostering intersectorial partnerships, advocating for policy change, establishing professional competencies and developing education and training programmes.
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ASH S, DOWDING K, PHILLIPS S. Mixed methods research approach to the development and review of competency standards for dietitians. Nutr Diet 2011. [DOI: 10.1111/j.1747-0080.2011.01552.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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